Obstetrics and Gynecology Commons^™

Fertility Transitions In Kenya And Ghana: Trends, Determinants And Implications For Policy And Programs, Ian Askew, Baker Ndugga Maggwa, Francis Onyango

Reproductive Health

No abstract provided.

The Balanced Counseling Strategy Plus: A Toolkit For Family Planning Service Providers Working In High Hiv/Sti Prevalence Settings (Supplemental Material In French), Population Council

Reproductive Health

The Balanced Counseling Strategy Plus (BCS+) toolkit, developed and tested in Kenya and South Africa, provides information and materials that healthcare providers need to offer complete, high-quality family planning counseling to clients living in areas with high rates of HIV and STIs. Content is in accordance with the 2015 WHO Medical Eligibility Criteria. The BCS+ provides evidence on clinical indications for the provision of family planning methods, counseling cards, instructions for providers, and guidance for supplemental counseling and services that family planning clients may need. The BCS+ includes user's guide, trainer's guide, algorithm, method brochures, and counseling cards. This publication …

The Balanced Counseling Strategy Plus: A Toolkit For Family Planning Service Providers Working In High Hiv/Sti Prevalence Settings, Population Council

Reproductive Health

The Balanced Counseling Strategy Plus (BCS+) toolkit, developed and tested in Kenya and South Africa, provides information and materials that healthcare providers need to offer complete, high-quality family planning counseling to clients living in areas with high rates of HIV and STIs. Content is in accordance with the 2015 WHO Medical Eligibility Criteria. The BCS+ provides evidence on clinical indications for the provision of family planning methods, counseling cards, instructions for providers, and guidance for supplemental counseling and services that family planning clients may need. This publication is the English language version of the user's guide, trainer's guide, algorithm, method …

The Balanced Counseling Strategy Plus: A Toolkit For Family Planning Service Providers Working In High Hiv/Sti Prevalence Settings (With Zika Information), Population Council

Reproductive Health

The Balanced Counseling Strategy Plus (BCS+) toolkit, developed and tested in Kenya and South Africa, provides information and materials that healthcare providers need to offer complete, high-quality family planning counseling to clients living in areas with high rates of HIV and STIs. Content is in accordance with the 2015 WHO Medical Eligibility Criteria. The BCS+ provides evidence on clinical indications for the provision of family planning methods, counseling cards, instructions for providers, and guidance for supplemental counseling and services that family planning clients may need. This publication is the English language version with Zika information of the user's guide, trainer's …

The Balanced Counseling Strategy Plus: A Toolkit For Family Planning Service Providers Working In High Hiv/Sti Prevalence Settings (Supplemental Material In Dari), Population Council

Reproductive Health

The Balanced Counseling Strategy Plus (BCS+) toolkit, developed and tested in Kenya and South Africa, provides information and materials that healthcare providers need to offer complete, high-quality family planning counseling to clients living in areas with high rates of HIV and STIs. Content is in accordance with the 2015 WHO Medical Eligibility Criteria. The BCS+ provides evidence on clinical indications for the provision of family planning methods, counseling cards, instructions for providers, and guidance for supplemental counseling and services that family planning clients may need. The BCS+ includes user's guide, trainer's guide, algorithm, method brochures, and counseling cards. This publication …

The Balanced Counseling Strategy Plus: A Toolkit For Family Planning Service Providers Working In High Hiv/Sti Prevalence Settings (Spanish Translation), Population Council

Reproductive Health

The Balanced Counseling Strategy Plus (BCS+) toolkit, developed and tested in Kenya and South Africa, provides information and materials that healthcare providers need to offer complete, high-quality family planning counseling to clients living in areas with high rates of HIV and STIs. Content is in accordance with the 2015 WHO Medical Eligibility Criteria. The BCS+ provides evidence on clinical indications for the provision of family planning methods, counseling cards, instructions for providers, and guidance for supplemental counseling and services that family planning clients may need. This publication is the Spanish language version of the user's guide, trainer's guide, algorithm, method …

The Characterization Of A Putative Virulence Factor Expressed By Sneathia Amnii, Amy Sanford

Theses and Dissertations

Preterm birth, defined at birth before 37 weeks gestation, affects millions of newborns worldwide every year. Preterm birth is a leading cause of infant morbidity and mortality. One major cause of preterm birth is preterm premature rupture of membranes (PPROM), which can be triggered by bacterial infection and inflammation. A bacterial species that has been implicated in preterm birth and other obstetric complications is Sneathia amnii. The goals of this study were to observe cytopathogenic effects caused by S. amnii strain Sn35 and identify putative virulence factors causing those effects. Sn35 was able to adhere to, invade, and damage/kill …

Human Rights In The New Global Strategy., Jyoti Sanghera, Lynn Gentile, Imma Guerras-Delgado, Lucinda O’Hanlon, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The Global Strategy for Women’s and Children’s Health (2010), with its emphasis on participatory decision making processes, non-discrimination, and accountability, affirmed the importance of human rights. Despite important gains following its launch women, children, and adolescents continue to experience serious violations of their health and health related human rights, including discrimination in access to quality healthcare. A human rights based approach must thus be fully integrated throughout the Global Strategy.

The right to health is recognised by several legal tools and treaties relating to human rights, including the International Covenant on Economic, Social and Cultural Rights; the Convention on the …

Women’S Health Priorities And Interventions, Marleen Temmerman, Rajat Khosla, Laura Laski, Zoe Mathews, Lale Say

Obstetrics and Gynaecology, East Africa

Over the past decades, governments have taken steps towards improving women’s health in line with commitments made in key international summits. Progress has been made in reducing maternal mortality,1 which accelerated with the launch of the United Nations secretary general’s Global Strategy for Women’s and Children’s Health in 2010. Use of maternal healthcare and family planning has increased in some countries.2 Progress has also been seen on two determinants of women’s health—school enrolment rates for girls and political participation of women—but not for others such as gender based violence.3

However, societies are still failing women in relation to health, especially …

How To Assess Success Of Treatment When Using Multiple Doses: The Case Of Misoprostol For Medical Abortion., Armando H. Seuc, Iqbal H. Shah, Moazzam Ali, Claudia Diaz-Olavarrieta, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The assessment of treatment success in clinical trials when multiple (repeated) doses (courses) are involved is quite common, for example, in the case of infertility treatment with assisted reproductive technology (ART), and medical abortion using misoprostol alone or in combination with mifepristone. Under these or similar circumstances, most researchers assess success using binomial proportions after a certain number of consecutive doses, and some have used survival analysis. In this paper we discuss the main problems in using binomial proportions to summarize (the overall) efficacy after two or more consecutive doses of the relevant treatment, particularly for the case of …

Global Estimates Of The Prevalence And Incidence Of Four Curable Sexually Transmitted Infections In 2012 Based On Systematic Review And Global Reporting, Lori Newman, Jane Rowley, Stephen Vander Hoorn, Nalinka Saman Wijesooriya, Magnus Unemo, Nicola Low, Gretchen Stevens, Sami Gottlieb, James Kiarie, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Quantifying sexually transmitted infection (STI) prevalence and incidence is important for planning interventions and advocating for resources. The World Health Organization (WHO) periodically estimates global and regional prevalence and incidence of four curable STIs: chlamydia, gonorrhoea, trichomoniasis and syphilis.

Methods and Findings: WHO’s 2012 estimates were based upon literature reviews of prevalence data from 2005 through 2012 among general populations for genitourinary infection with chlamydia, gonorrhoea, and trichomoniasis, and nationally reported data on syphilis seroprevalence among antenatal care attendees. Data were standardized for laboratory test type, geography, age, and high risk subpopulations, and combined using a Bayesian meta-analytic approach. …

Low-Grade Serous Carcinoma – The Clinical Challenge, Khadija Warfa, Martin Kobel, Prafull Ghatage, Gregg Nelson

Obstetrics and Gynaecology, East Africa

Low-grade serous carcinoma is one of the five major histological types of ovarian carcinoma associated with a specific biology. We reviewed three cases from our institution to demonstrate the variable clinical course and provide a brief review on this disease entity.

Assessing Predictors Of Contraceptive Use And Demand For Family Planning Services In Underserved Areas Of Punjab Province In Pakistan: Results Of A Cross-Sectional Baseline Survey, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque, Ghulam Mustafa, Waqas Hameed, Omar Farooq Khan, Ghazunfer Abbas, Marleen Temmerman, Erik Munroe

Obstetrics and Gynaecology, East Africa

Background: Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed.

Method: A cross-sectional baseline household survey …

Implementation Of Point-Of-Care Diagnostics Leads To Variable Uptake Of Syphilis, Anemia And Cd4+ T-Cell Count Testing In Rural Maternal And Child Health Clinics, Caroline De Schacht, Carlota Lucas, Nádia Sitoe, Rhoderick Machekano, Patrina Chongo, Marleen Temmerman, Ocean Tobaiwa, Laura Guay, Seble Kassaye, Ilesh V. Jani

Obstetrics and Gynaecology, East Africa

Introduction: Anemia, syphilis and HIV are high burden diseases among pregnant women in sub-Saharan Africa. A quasi-experimental study was conducted in four health facilities in Southern Mozambique to evaluate the effect of point-of-care technologies for hemoglobin quantification, syphilis testing and CD4+ T-cell enumeration performed within maternal and child health services on testing and treatment coverage, and assessing acceptability by health workers.

Methods: Demographic and testing data on women attending first antenatal care services were extracted from existing records, before (2011; n = 865) and after (2012; n = 808) introduction of point-of-care testing. Study outcomes per health facility were compared …

Couple Based Family Planning Education: Changes In Male Involvement And Contraceptive Use Among Married Couples In Jimma Zone, Ethiopia, Tizta Tilahun, Gily Coene, Marleen Temmerman, Olivier Degomme

Obstetrics and Gynaecology, East Africa

Background: Family planning contributes substantially in achieving the Millennium Development Goals. Recently,male involvement has gained considerable attention in family planning programs but the implementation thereof remains a challenge. In that context, our study aimed at measuring the effect of a six-month-long family planning education program on male involvement in family planning, as well as on couples’ contraceptive practice.

Methods: We conducted a quasi-experimental research among 811 married couples in Jimma Zone, southwest Ethiopia. Our study consisted of an intervention and a control group for comparative purpose; and surveyed before and after the implementation of the intervention. The intervention consisted of …

A Cross Sectional Comparison Of Postnatal Care Quality In Facilities Participating In A Maternal Health Voucher Program Versus Non-Voucher Facilities In Kenya, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Francis Obare, Rebecca Njuki, Marleen Temmerman, Ben Bellows

Obstetrics and Gynaecology, East Africa

Background: Health service fees constitute substantial barriers for women seeking childbirth and postnatal care. In an effort to reduce health inequities, the government of Kenya in 2006 introduced the output-based approach (OBA), or voucher programme, to increase poor women’s access to quality Safe Motherhood services including postnatal care. To help improve service quality, OBA programmes purchase services on behalf of the poor and marginalised, with provider reimbursements for verified services. Kenya’s programme accredited health facilities in three districts as well as in two informal Nairobi settlements.

Methods: Postnatal care quality in voucher health facilities (n = 21) accredited in 2006 …

Induced Abortion In 30 Chinese Provinces In 2013: A Cross-Sectional Survey, Shangchun Wu, Marleen Temmerman, Kun Wang, Shuchen Wang, Jiong Li, Wei-Hong Zhang

Obstetrics and Gynaecology, East Africa

Background: Galloping economic growth and reform in China in the past 30 years has led to dramatic social changes. Attitudes towards sex and sexual behaviour have changed, and premarital sex has become more acceptable. The methods of contraception have changed, and the use of highly effective or long-acting contraceptive methods tends to be decreasing, especially in urban areas. Abortion is commonly used to end unintended pregnancy. The aim of this study was to survey the current situation of induced abortions in selected hospitals in 30 provinces in China.

Methods: This cross-sectional study was conducted in 295 randomly selected hospitals in …

Quality At The Centre Of Universal Health Coverage, Howard L. Sobel, Dale Huntington, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The last decade of the MDG era witnessed substantial focus on reaching the bottom economic quintiles in low and middle income countries. However, the inordinate focus on reducing financial risk burden and increasing coverage without sufficient focus on expanding quality of services may account for slow progress of the MDGs in many countries. Human Resources for Health underlie quality and service delivery improvements, yet remains under-addressed in many national strategies to achieve Universal Health Coverage. Without adequate investments in improving and expanding health professional education, making and sustaining gains will be unlikely. The transition from the Millennium Development Goals (MDG) …

Determinants Of Method Switching Among Social Franchise Clients Who Discontinued The Use Of Intrauterine Contraceptive Device, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Wajahat Hussain, Ghulam Mustafa, Muhammad Ishaque, Safdar Ali, Aftab Ahmed, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Introduction: Women who do not switch to alternatemethods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether.

Methods: The data used for this study comes from a larger cross-sectional survey conducted in nine

(9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who …

The Perceptions Of The Preparedness Of Medical Graduates To Take On Internship Responsibilities In Low Resource Hospitals In Kenya, Patricia Muthaura, Tashmin Khamis

Obstetrics and Gynaecology, East Africa

The Aga Khan University is developing an Undergraduate Medical Education (UGME) curriculum for implementation in East Africa in 2016, which aims to serve the health needs of the populations there. Pilot focus group discussions of recent interns were conducted at the Aga Khan University Hospital, Nairobi to find out: (1) If Kenyan medical students are adequately prepared for their roles as interns in low resource hospitals upon graduation from medical schools; (2) The likely clinical conditions that interns will face in low resource hospitals in Kenya; and (3) How might the UGME curriculum best prepare interns for their roles in …